GERD and Hiatal Hernia: Could LINX® Reflux Management System Be Right for You?

Acid reflux, heartburn, and indigestion are all common symptoms of gastroesophageal reflux disease or GERD. This common problem afflicts over 20 million people every day here in the United States.

A hiatal hernia is when the stomach slips up into the chest. Hiatal hernias can worsen acid reflux because the typical sphincter mechanism in the lower esophagus is dysfunctional, and there is a mechanical disturbance of the natural flow of solid foods and liquids. Pregnancy, obesity, coughing, or constipation increase intra-abdominal pressure, which can worsen the symptoms of reflux and worsen a hiatal hernia.

Generally, hiatal hernias occur more often for patients who are overweight, women, and over 50 years old. Hiatal hernias can be diagnosed with upper endoscopy (EGD), an esophagram or upper gastrointestinal (UGI) series.

The LINX® Reflux Management System is a small and flexible band of interlined titanium beads with magnetic cores. To select the right size, the esophagus is measured with a specialized tool for all patients undergoing placement of a LINX device. First, a necklace-like tool is placed around the lower esophagus at the level of the lower esophageal sphincter (LES) to get the best fit for the LINX device. The measurement tool is then removed, and the LINX device is implanted, making sure the ends of the band are aligned and securely linked.

Magnetic attraction between the beads helps the lower sphincter resist opening to gastric pressures, preventing reflux of the acidic content in the stomach into the esophagus. The device is designed so that normal swallowing pressures temporarily break the magnetic bond, allowing food and liquid to pass normally into the stomach. Due to the magnetic attraction, the device will assist in closing the lower sphincter immediately after swallowing, augmenting the lower esophageal sphincter and restoring the body’s natural barrier to reflux.

If you suffer from GERD and would like to decrease, or in some cases, completely stop taking medication for this problem, the LINX® Reflux Management System could be the perfect solution for you. Schedule an appointment at VIPSurg to learn more.

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Stats Don’t Lie: Learn How Bariatric Surgery is Helping Hundreds of Thousands of People Regain Their Health

In the early nineties, fewer than twenty thousand bariatric surgeries were performed in the U.S. each year. Now the number is around two hundred thousand. Only in the past few years has what was once considered a high-risk and extreme measure been transformed into a relatively standard, safe, and straightforward one. There is strong consensus that bariatric surgery is effective, and Medicaid now covers it in forty-eight states. 

Research into conventional weight-loss methods has repeatedly pointed to an overwhelmingly dispiriting conclusion—that diet and exercise alone, no matter how disciplined the individual, fail all too often. Still, only about one per cent of those who medically qualify for bariatric surgery get it. 

Over the centuries, suggested strategies for losing weight have included bitter tonics, bleeding, sea air, amphetamines, Turkish baths, tapeworms, purgatives, low-fat diets, high-fat diets, cinnamon, more sleep, less sleep, and the “vigorous massage of the body with pea-flour.” Surgery is an old idea, too. One of the earliest surgical approaches to weight loss, dating back at least a millennium, was simple: the jaw was wired mostly shut. Another story from pre-anesthesia days tells of a rabbi “being given a sleeping potion and taken into a marble chamber, where his abdomen was opened, and many baskets of fat were removed.”

But the health risks associated with obesity have become apparent—higher rates of stroke and heart disease, Type 2 diabetes, infertility, sleep apnea, osteoarthritis, and an increased risk of certain cancers. In addition, bariatric procedures have improved dramatically. 

Robotic surgery and laparoscopy, which became the norm in the past decade, result in fewer complications like hernias. Physicians now have a better sense of how to prevent and treat the complications of surgery. 

As recently as seventeen years ago, there was a one-per-cent chance of dying from a bariatric procedure—a relatively high risk. Now it is 0.15 percent, which is less than that for a knee replacement, a procedure commonly recommended to people who have developed joint problems from carrying around excessive weight.

Around seventy-five per cent of bariatric patients have sustained weight loss five years after their surgery, and that percentage is higher if you don’t include lap-band patients in the analysis. Weight loss through diet and exercise rarely leads to more than short-term changes—a quite small percentage of patients see sustained weight loss. 

Today, obesity is second only to tobacco as a killer in this country. If you live in the Las Vegas area and are seeking long-term weight loss and health benefits, schedule an appointment at VIPSurg. We will help you find the best treatment for your unique situation.

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Life After Bariatric Surgery

For many who think weight-loss surgery may be the only way to be healthy and live longer, the fear of how life might be after the procedure keeps them from taking life-saving measures. Be informed so that you can make educated decisions about your health. These facts can help you on the way to knowing what’s best for you and give you a glimpse into what one can usually expect after surgery.

Your recovery will depend on which procedure you choose (gastric sleeve, gastric bypass, lap-band, and duodenal switch surgery). For example:

  • Average Hospital Stay: Ranges from outpatient (return home same-day) to 2-3 days
  • Average Time Until Back to Work: Ranges from 3 days to 2 weeks
  • Average Time to Full Recovery: Ranges from 3 days to 6 weeks
  • Pain: Ranges from mild discomfort to manageable with pain medication
  • Diet: Ranges from a few limited foods to a strict and slow transition from clear liquids to solid foods
  • Back-to-Normal Activity: Ranges from 3 days to 4-6 weeks

Life after weight loss surgery includes (depending on your chosen procedure):

  • Full recovery in 1 to 6 weeks
  • Excess weight loss between 25% and 90+%
  • Many obesity-related health problems cured or improved
  • Significant diet and exercise changes
  • Good and bad changes in how friends, family, and strangers treat you
  • Challenges such as sagging skin, digestion issues, and weight regain

Improvements to your physical health can be as impressive as your rapid weight loss family-eating-at-the-table-619142_1920after bariatric surgery. Conditions such as Type 2 Diabetes, high blood pressure, GERD, and other issues related to metabolic syndrome have been shown to get better or completely go away following gastric sleeve, gastric bypass, lap-band, and duodenal switch surgery.

It is important to emphasize making healthy food and lifestyle choices even before weight-loss surgical procedures. Bariatric surgery is a tool. Use it to make changes for a long, healthy, productive, and happy life.

If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment at VIPSurg. Our team can help find the perfect treatment for you!

Visual Cues that Make Portion Control Easy

To reach or stay at a healthy weight, how much you eat is just as important as what you eat. How many calories you need each day to lose weight or maintain your weight depends on your age, weight, metabolism, whether you are male or female, how active you are, and other factors. Portion control is important when you’re trying to lose weight and keep it off.

When you’re filling your plate, picture these items to help remind you of proper serving sizes:

  • Protein — Most Americans get way more than enough protein every day. A proper single portion of meat is just 3 ounces – about the size of a deck of cards, a standard smart phone, or the palm of your hand (no fingers).
  • Starches and Grains — Portions have gotten so out of control that over-sized bakery My plate - portion control guideitems have become the norm. Instead of assuming one muffin means one serving, picture this: a bagel portion should look like a regular size can of tuna; a pancake should be the size of a CD; and a muffin should be the size of a hockey puck. The amount of cereal in your bowl should be the size of a baseball, and your rice or pasta side dish should be the size of a tennis ball.
  • Fruits and Vegetables — Fruits are rich in many vitamins and minerals, so they are an essential part of your diet, but they are also a source of sugar. When consuming fruit, keep your portion to about the size of a tennis ball. A portion of cooked vegetables should be the size of a baseball, and a portion of raw vegetables should be the size of two baseballs.
  • Fats — Fats have gotten a bad reputation because they are high in calories and can lead to weight gain when eaten in excess; however, healthy fats, like olive oil and avocado, are a crucial part of a healthy fat. Keep your portions in check by picturing two stacked dice or a poker chip when serving yourself a fat source.

The quantities mentioned here were formulated by U.S.D.A and derived based on energy utilized by the average modern-day human.

For most of us, trying to remember the serving quantities of various foods seems like an impossible task. Fortunately, there is a simpler way of doing things. Follow this last tip regularly, to keep portions in control — Take a 9-inch dinner plate and visualize it divided into four parts – each containing one of the four recommended food groups i.e. fruit, vegetables, lean proteins and whole grains.

If you are interested in bariatric surgery, schedule an appointment at ViPSurg. Our expert team will find the right treatment for you.

Start Small for Big Results

If you are obese or overweight, exercise can be a tricky topic. Often, working out with extra weight becomes a vicious, negative cycle. Excess body weight puts stress on your joints, bones, and connective tissue, so when you do try to start a regular exercise routine, you end up hurting yourself, making many workouts too uncomfortable or even impossible to do. However, even though your knees probably hurt, your back probably hurts, and you probably already don’t feel good, you must start somewhere.

At the risk of generalizing, often gyms just aren’t that big-person friendly. When you’re obese, walking into a space where other people are already fit can be quite intimidating. On the other hand, for some, going to the gym is what motivates them, and there are certainly good choices for overweight and obese people. Cross-trainers and recumbent bikes all alleviate impact on the joints and lower back as do swimming and aqua aerobics.

For those who wish for something that doesn’t require machines or specialized equipment, here are some simple ways to get started at home:

  • Make A Plan Find the smallest thing you can do right now and commit to doing it every day. “Today I will walk around the block.” Or “Today I will spend 10 minutes doing chair exercises.”  Once you’ve met your small goal for the week, you can always add just a little more to it.
  • Enlist Support — Find someone in your life – a colleague, family member, or next-door neighbor – who will support and encourage you. The use of social support is an undisputed strategy for success. You don’t need another lecture about the health dangers of being overweight; you need positive motivation to make healthier choices.
  • Start Slow — The goal is to start exercising little by little, not to overdo it and end up frustrated, burnt out, or hurt right away. Gentle, easy exercise is the way to begin!

Just as not exercising becomes a routine, so can doing simple and easy workouts. Soon you’ll be craving something a little more challenging. Listen to your body and be aware of problems, but the bottom line is that most of us can do some kind of physical activity to make us healthier.

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Let’s Not Sugar Coat It – Carbs Get a Bad Rap

Over the past few years, carbohydrates, especially refined sugar, have gotten a bad reputation. Unfortunately, an “all-or-nothing” restriction could be causing many people to eventually binge on these foods, often leading to weight gain and the problems that accompany obesity. Despite the messages in the media about the dangers of carbs and sugars, it is important to remember that not all carbohydrates are bad.

As a matter of fact, to boost your metabolism and ultimately lose weight, one must incorporate good carbs into their daily diet. Good carbs provide vital nutrients and essential fibers and help you stay full.

What are good carbs?

Good carbs are complex carbs that provide energy and nutritional value. For example, whole grains like quinoa, barley, faro, brown rice, and vegetables like sweet potatoes, brussels sprouts, or artichokes. Whole grain breads and pastas are easy to incorporate into your diet. These foods will keep you energized for a long period of time and are a healthy staple to any meal.

What are bad carbs?

Bad carbs are refined carbs, often filled with added sugar and devoid of nutritional photo-1458938354258-3e66eb36eb7bvalue. Examples of these would include foods containing refined grains like white rice and foods containing white flour like bread, pasta, and pastries. Bad carbs will provide temporary relief of hunger, but since the nutritional value is so low, the feeling of fullness is short-lived.

Remember, carbs do have their value, and that value should not be underestimated. Whole grains are reliable suppliers of energy; they take longer to break down than refined carbs, and they help make you feel fuller and more satisfied. Whole-grain carbs, when taken in the right portions, are not usually the issue when it comes to weight gain.

Also remember that no diet is perfect. While a well-balanced diet should predominantly include complex carbohydrates, eating simple carbohydrates in moderation will not necessarily make you gain weight or cause chronic diseases.

According to the American Heart Association, women should have no more than six teaspoons of sugar a day and men should have no more than nine. Consuming large amounts of refined sugar is hard on your whole body. It can cause weight gain, high cholesterol, and diabetes, but it also effects mood, sleep, skin, and digestion.

If you are looking for ways to treat severe obesity, schedule a consultation at VIPSurg. Our doctors are experts at bariatric surgery and can help find the right treatment for you.

How Much Water is Enough?

You may have heard that you should aim to drink eight 8-ounce glasses of water per day. How much you should actually drink is more individualized than you might think. The Institute of Medicine (IOM) currently recommends that men should drink at least 104 ounces of water per day, which is 13 cups.

They say women should drink at least 72 ounces, which is 9 cups. Even still, the answer to exactly how much water you should drink isn’t so simple.

While the eight glasses rule is a good start, it isn’t based on solid, well-researched information. Your body weight is made up of 60 percent water. While every system in your body needs water to function, your recommended intake is based on factors including your sex, age, activity level, and others, such as if you’re pregnant or breastfeeding.

The current IOM recommendation for people ages 19 and older is around 3.7 liters for men and 2.7 liters for women. However, this is your overall fluid intake per day, including anything you eat or drink containing water in it, like fruits or vegetables.

Of this total, men should drink around 13 cups from beverages. For women, it’s 9 cups.
If you find it challenging to get in all that water each day, here are a few tips to help:

  • Measure out the water you plan to drink for the day. This gives you a visual reminder as well as lets you see your progress throughout the day.
  • Have a plan. Have a certain amount you want to get in by lunch time. Set aside what is left for the afternoon, perhaps making it so there will be a smaller amount remaining for the early evening.
  • As you sip your way through the day if you find you’re not going to make it, add some fresh squeezed lemon to your water and a few drops of natural sweetener.

In addition to the general health benefits of proper hydration, for years, dieters have been drinking lots of water as a weight loss strategy. While water doesn’t have any magical effect on weight loss, substituting it for higher calorie beverages can certainly help. Also, food with high water content tends to look larger, its higher volume requires more chewing, and it is absorbed more slowly by the body, which helps you feel full. Water-rich foods include fruits, vegetables, broth-based soups, oatmeal, and beans.

If you live in the Las Vegas area and are interested in bariatric surgery, schedule an appointment with VIPSurg. Drs. Tsuda and Ryan are ready to help you find the right solution for your unique situation.

person drinking water